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Factors associated with COVID-19-related death using OpenSAFELY

Author

Listed:
  • Elizabeth J. Williamson

    (Faculty of Epidemiology and Population Health)

  • Alex J. Walker

    (University of Oxford)

  • Krishnan Bhaskaran

    (Faculty of Epidemiology and Population Health)

  • Seb Bacon

    (University of Oxford)

  • Chris Bates

    (TPP)

  • Caroline E. Morton

    (University of Oxford)

  • Helen J. Curtis

    (University of Oxford)

  • Amir Mehrkar

    (University of Oxford)

  • David Evans

    (University of Oxford)

  • Peter Inglesby

    (University of Oxford)

  • Jonathan Cockburn

    (TPP)

  • Helen I. McDonald

    (Faculty of Epidemiology and Population Health
    NIHR Health Protection Research Unit in Immunisation)

  • Brian MacKenna

    (University of Oxford)

  • Laurie Tomlinson

    (Faculty of Epidemiology and Population Health)

  • Ian J. Douglas

    (Faculty of Epidemiology and Population Health)

  • Christopher T. Rentsch

    (Faculty of Epidemiology and Population Health)

  • Rohini Mathur

    (Faculty of Epidemiology and Population Health)

  • Angel Y. S. Wong

    (Faculty of Epidemiology and Population Health)

  • Richard Grieve

    (Faculty of Epidemiology and Population Health)

  • David Harrison

    (Intensive Care National Audit and Research Centre (ICNARC))

  • Harriet Forbes

    (Faculty of Epidemiology and Population Health)

  • Anna Schultze

    (Faculty of Epidemiology and Population Health)

  • Richard Croker

    (University of Oxford)

  • John Parry

    (TPP)

  • Frank Hester

    (TPP)

  • Sam Harper

    (TPP)

  • Rafael Perera

    (University of Oxford)

  • Stephen J. W. Evans

    (Faculty of Epidemiology and Population Health)

  • Liam Smeeth

    (Faculty of Epidemiology and Population Health
    NIHR Health Protection Research Unit in Immunisation)

  • Ben Goldacre

    (University of Oxford)

Abstract

Coronavirus disease 2019 (COVID-19) has rapidly affected mortality worldwide1. There is unprecedented urgency to understand who is most at risk of severe outcomes, and this requires new approaches for the timely analysis of large datasets. Working on behalf of NHS England, we created OpenSAFELY—a secure health analytics platform that covers 40% of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records. Here we used OpenSAFELY to examine factors associated with COVID-19-related death. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19-related deaths. COVID-19-related death was associated with: being male (hazard ratio (HR) 1.59 (95% confidence interval 1.53–1.65)); greater age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared with people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors (HR 1.48 (1.29–1.69) and 1.45 (1.32–1.58), respectively). We have quantified a range of clinical factors associated with COVID-19-related death in one of the largest cohort studies on this topic so far. More patient records are rapidly being added to OpenSAFELY, we will update and extend our results regularly.

Suggested Citation

  • Elizabeth J. Williamson & Alex J. Walker & Krishnan Bhaskaran & Seb Bacon & Chris Bates & Caroline E. Morton & Helen J. Curtis & Amir Mehrkar & David Evans & Peter Inglesby & Jonathan Cockburn & Helen, 2020. "Factors associated with COVID-19-related death using OpenSAFELY," Nature, Nature, vol. 584(7821), pages 430-436, August.
  • Handle: RePEc:nat:nature:v:584:y:2020:i:7821:d:10.1038_s41586-020-2521-4
    DOI: 10.1038/s41586-020-2521-4
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